Pan-Pan Hao

Acetylation-dependent regulation of mitochondrial ALDH2 activation by SIRT3 mediates acute ethanol-induced eNOS activation.

Moderate alcohol consumption has beneficial effects on endothelial nitric‐oxide synthase (eNOS) activation, which can engender an array of anti‐atherogenic actions. Here we show that in human aortic endothelial cells (HAECs), rapid activation of mitochondrial aldehyde dehydrogenase 2 (ALDH2) mediates ethanol‐induced eNOS activation by preventing reactive oxygen species (ROS) accumulation. Furthermore, activation of ALDH2 by ethanol is due to its hyperacetylation by SIRT3 inactivation. These data suggest that ethanol‐induced eNOS activation in HAECs may be dependent on ALDH2 hyperacetylation by SIRT3 inactivation.

Angiotensin II type 1 receptor gene A1166C polymorphism and essential hypertension in Chinese: a meta-analysis

Introduction. We performed a meta-analysis with the aim of assessing the association of the angiotensin II type 1 (AT1) receptor gene A1166C polymorphism with essential hypertension in Chinese case-control studies. Methods. Studies were searched from the Chinese Biomedicine Database, the China National Knowledge Infrastructure platform, Pubmed and Medline, using the search terms ‘hypertension’, ‘angiotensin II type 1 receptor’, ‘AT1R’, ‘polymorphism’, ‘China’ and ‘Chinese’, without limiting to any specific language. The strength of the association between the A1166C polymorphism and hypertension was evaluated by the odds ratio (OR) with the corresponding 95% confidence interval (CI). The analyses were performed with Cochrane RevMan software version 4.2. Results. Overall, the variant genotype AC/CC was associated with a statistically increased essential hypertension risk with the pooled OR 1.48 (95% CI: 1.20—1.83). In the subgroup analyses, the association was also significant among studies using Northern populations, Southern populations, Han Chinese and hospital-based controls. The age did not influence the relationship between the AT 1 receptor A1166C polymorphism and hypertension in the subgroup analyses. Conclusions. The present meta-analysis suggests that the AT1 receptor 1166 AC/CC genotype is associated with susceptibility to hypertension in the Chinese population.

Traditional Chinese medication for cardiovascular disease

Traditional Chinese medication (TCM) is increasingly used to treat cardiovascular disease (CVD) in China and some other Asian countries. However, therapeutic efficacy and adverse effects of TCM are difficult to evaluate because few large-scale, randomized controlled trials (RCTs) enrolling patients with CVD have been performed. In this Review, we critically examine the current evidence on the cardiovascular effects of TCM. We reviewed 68 RCTs that included a total of 16,171 patients. The methodological quality of the trials was generally low. Only three reports described adverse cardiovascular events specifically, although in most studies TCM was associated with significant improvements in surrogate end points for hypertension, coronary heart disease, cardiac arrhythmias, and heart failure. The risk of adverse effects was not increased compared with no intervention, placebo, or Western medications. However, whether TCM is effective in reducing the all-cause or cardiovascular mortality in patients with CVD remains unknown and must be tested in large-scale RCTs with adverse cardiovascular events as primary end points.

Efficacy and safety of intensive insulin therapy for critically ill neurologic patients: a meta-analysis.

BACKGROUND Whether intensive insulin therapy (IIT) may improve clinical outcomes for patients admitted to intensive care units, especially critically ill neurologic patients, is still debated. In the present study, we performed a meta-analysis of literature comparing the efficacy and safety of IIT and conventional insulin therapy (CIT) for critically ill neurologic patients in terms of mortality, infection rate, neurologic outcome, and hypoglycemia. METHODS We searched for published reports of studies of randomized control trials (up to March 10, 2011) of patients admitted to neurologic intensive care units and investigated an IIT (target of blood glucose control <120 mg/dL) with a control of CIT. Data were abstracted by a standardized protocol. RESULTS We retrieved reports of five studies involving 924 patients. The risk of mortality, infection rate, and neurologic outcome did not differ with IIT or CIT. However, the incidence of hypoglycemic episodes was significantly higher with IIT than CIT (78.8% vs. 48.9%), with a relative risk of 2.62 (95% confidence interval [CI]: 1.07-6.43; p < 0.04). CONCLUSIONS As compared with CIT, IIT may not benefit critically ill neurologic patients in terms of mortality, infection rate, or neurologic outcome and in fact may be associated with increased hypoglycemic complications. Therefore, IIT cannot be recommended over conventional control for critical neurologic disease, but further study is warranted.

Alcohol ingestion and colorectal neoplasia: a meta-analysis based on a Mendelian randomization approach.

Aim  Observed associations of alcohol with colorectal cancer are prone to distortion by confounding and reverse causation. A Mendelian randomization approach provides an unbiased estimate of the association using the aldehyde dehydrogenase 2 (ALDH2) variant as a surrogate of alcohol exposure.

Benefits of Early Tracheotomy: A Meta-analysis Based on 6 Observational Studies

BACKGROUND: Whether early tracheotomy can improve the clinical outcomes of critically ill patients remains controversial. The current study aimed to discuss the potential benefits of early tracheotomy compared to late tracheotomy with meta-analysis of observational studies. METHODS: An electronic search (up to February 28, 2013) was conducted by a uniform requirement, and then clinical data satisfying the predefined inclusion criteria were extracted. RESULTS: Data from a total of 2,037 subjects were included from 6 observational retrospective studies. Meta-analysis suggested that early tracheotomy was associated with significant reductions in mortality (odds ratio 0.77, 95% CI 0.62–0.96), duration of mechanical ventilation (mean difference −10.04, 95% CI –15.15 to −4.92), ICU stay (mean difference −8.80 d, 95% CI –9.71 to −7.89 d), and hospital stay (mean difference −12.18 d, 95% CI –18.25 to −6.11 d). However, as compared with late tracheotomy, early tracheotomy did not reduce the incidence of ventilator-associated pneumonia. CONCLUSIONS: Our meta-analysis of retrospective observational studies suggests that early tracheotomy performed between days 3 and 7 after intubation had some advantages, including decreased mortality and reduced ICU stay, hospital stay, and mechanical ventilation duration in ICU patients.

Evidence for traditional Chinese medication to treat cardiovascular disease.

We thank Dr Xingjiang Xiong for his Correspondence (Integrating traditional Chinese medicine into Western cardiovascular medicine: an evidence-based approach. Nat. Rev. Cardiol. doi:10.1038/ nrcardio.2014.177-c1)1 on our Review article (Traditional Chinese medication for cardiovascular disease. Nat. Rev. Cardiol. 12, 115–122; 2015).2 We would like to take the opportunity to clarify a few issues raised by Dr Xiong. First, we defined ‘TCM’ as ‘traditional Chinese medication’ rather than ‘traditional Chinese medicine’ in our Review, which was clearly stated in the abstract and introduction.2 This distinction is important because most therapeutic effects of traditional Chinese medicine on cardiovascular diseases have stemmed from Chinese herbal medication, although a number of nonpharmacological therapies (such as dietary supplements, acupuncture, moxibustion, massage, and exercise) exist, with scarce evidence from randomized clinical trials (RCTs). Dr Xiong suggests that “numerous appropriate studies on Chinese herbal medicine for the treatment of hypertension”1 had been omitted from our Review. However, owing to the poor quality of most RCTs of TCM for the treatment of cardiovascular diseases, we had to set strict selection criteria for these RCTs. Consequently, only 68 RCTs out of 1,541 eligible reports identified satisfied our criteria. The two studies given as examples by Dr Xiong were excluded from our Review for the following reasons. In the first study, Tong et al. reported blood pressures before and after treatment only in graphs (Figure 3 in their study), but not in numbers and, therefore, we were unable to extract quantitative data from this paper.3 The second study by Xu et al. had a Jadad score of 1,4 which did not meet our inclusion criteria. A major problem with this study was that some individuals were excluded owing to serious REPLY

Cardiogenic shock from acute ST-segment elevation myocardial infarction induced by severe multivessel coronary vasospasm

A 43-year-old woman was brought to the emergency room after acute onset chest pain and dizziness developed while at rest. She developed excruciating chest pain followed by drop of systolic blood pressure to 67 mmHg. Cardiothoracic examination revealed bilateral diffuse moist rales. An 18-lead electrocardiogram showed ST-segment elevation in leads II, III, aVF, and V3R through V5R. Initial assessment of …

Erratum: Traditional Chinese medication for cardiovascular disease

Nat. Rev. Cardiol. 12, 115–122 (2015); doi:10.1038/nrcardio.2014.177 In the version of this article initially published online and in print, reference 26 was incorrect. The error has been corrected in the HTML and PDF versions of the article.

Intracoronary Glycoprotein IIb/IIIa Inhibitors Improve Short-Term Mortality and Reinfarction in East Asian Patients with ST-Segment Elevation Myocardial Infarction after Thrombus Aspiration: A Meta-Analysis

Objective Intracoronary (IC) glycoprotein IIb/IIIa inhibitors (GPIs) after thrombus aspiration (TA) for patients with ST-segment elevation myocardial infarction (STEMI), as compared with percutaneous coronary interventions (PCI) alone, is still on debate. To address this issue, we performed a meta-analysis of results from prospective or randomized controlled trials on the topic. Methods We searched electronic and printed sources (up to June 20, 2016) according to the selection criteria. Data were abstraction and meta-analysis was performed using RevMan 5.3 software. Results The cohorts involved 14 articles describing 1,918 participants were included. The incidence of the short-term major adverse cardiac events (MACE) was significantly reduced with intracoronary GPIs after TA (odds ratio [OR]: 0.29; 95% confidence interval [CI]: 0.13 to 0.65, p=0.003). Benefits were noted for short-term mortality (OR: 0.31; 95% CI: 0.17 to 0.57, p=0.0002) and reinfarction (OR: 0.28; 95% CI: 0.10 to 0.78, p=0.01) in subjects who received intracoronary GPIs after TA. Moreover, the Thrombolysis in Myocardial Infarction (TIMI) trial grade 3 postprocedure (OR: 2.29; 95% CI: 1.72 to 3.04, P<0.00001) and complete ST-segment resolution (STR) rate (OR: 2.68; 95% CI: 1.85 to 3.87, P<0.00001) were both improved with intracoronary GPIs after TA. As a result, left ventricular ejection fraction (LVEF) at short-term follow-up showed a significant difference (OR: 7.33; 95% CI: 5.60 to 9.06, p<0.0001) in favor of the TA and intracoronary GPIs administration. Conclusions Our study demonstrates that intracoronary GPIs may have a synergistic effect with thrombus aspiration on short-term mortality, reinfarction, and cardiac functional recovery.